Panacea Journal of Medical Sciences 2023;13(1):250–255 Content available at: https://www.ipinnovative.com/open-access-journals Panacea Journal of Medical Sciences Journal homepage: http://www.pjms.in/ Case Series Interesting case series on distinct histopathological findings of six cases of epididymo-orchitis Shubha Sangeetha 1 , Nikita Jaju 1, *, Prakhar Garg 1 , Manjunatha Y A 1 1 Dept. of Pathology, Dr. B R Ambedkar Medical College and Hospital, Bangalore, Karnataka, India ARTICLE INFO Article history: Received 01-03-2022 Accepted 05-05-2022 Available online 07-04-2023 Keywords: Acid Fast Bacilli (AFB) Cryptorchid testis Granulomatous orchitis Testicular torsion Surgical castration ABSTRACT Background: Several clinicopathological illnesses impact the testis and paratesticular area, which are divided into non-neoplastic and neoplastic diseases. Despite the availability of imaging and tumor marker testing, histopathological examination is the primary method for diagnosing testicular lesions. Common indications of orchidectomy for non-neoplastic lesions are cryptorchidism, epididymitis and testicular torsion. Few non- neoplastic lesions present as mimickers of neoplasm with commonest being granulomatous orchitis and AFB positivity detected only in 2.1% of cases with bilateral presentation being rarest. Aim: We report here a series of six cases of epididymo-orchitis to discuss the histopathological spectrum with varied etiologies. Cases: Age of the patients ranged between 33-65yr old males. Amongst six cases, two of them were clinically and radiologically suspected as neoplastic lesions, which were histopathologically diagnosed as granulomatous epididymo-orchitis with one among it showing strong positivity for AFB, and two cases as testicular torsion with orchitis and one of the case was diagnosed as cryptorchid testis with foci of atypical germ cell and last case was reported as mild non-specific orchitis, for surgical castration. In this study, we also noted unilateral presentation being the commonest, specifically of Right side. Conclusion: Knowledge of histopathological spectrum of epididymo-orchitis is of prime importance to detect underlying specific etiology for targeted therapy and prevent undue orchidectomy. In this study, two cases which were clinically suspected as neoplastic lesions, were confirmed as granulomatous epididymo-orchitis on histopathological examination with one case showing strong AFB positivity. In this study, we noted late presentation (5th decade) of cryptorchidism with some atypical germ cells which are forerunner of malignancy. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact: reprint@ipinnovative.com 1. Introduction From benign congenital diseases to life-threatening cancers and acute surgical emergencies, testicular and paratesticular lesions can represent a wide spectrum of medical difficulties. 1 These lesions affect people of all ages, with scrotal swelling and pain being the most common * Corresponding author. E-mail address: jajunikita1996@gmail.com (N. Jaju). symptoms. 2 Cryptorchid testis, testicular atrophy, testicular torsion, inflammation, infection such as tuberculosis, infertility, and other non-neoplastic diseases are examples of benign lesions. Testicular cancer accounts for one percent of all male cancers worldwide. 3 In the absence of epididymitis, orchitis manifests as testicular swelling and pain. The onset is usually abrupt and might be unilateral or bilateral in nature. Fever, nausea, and vomiting are very typical symptoms. Swollen testicles https://doi.org/10.18231/j.pjms.2023.049 2249-8176/© 2023 Innovative Publication, All rights reserved. 250